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Rodriguez Miguel/Miami Dade C MAY-12-2,* 111:1. ~qp I, as 17:05 CITY M I AM I BCH CLERK DEPT 305 6737254 P.01 n.I ~ .. -' atv of MiamI Beach omce of tile CAyOe!'1 1700 Convention CentB" OrNe, Miami Bead'l, FL 13139 LOBBY1ST UGlSTllAnON IlOD LAlbIlyIIf I",,,.w JIIldllftS ~ or ~ VIINtIler ~III fII'''' fJr iI priICiPJI who.-lc, D m..uu,ay,. the pasggIr,'" <iF modIl;.1tIQC\ f8 an, 0rGClIl'Q. NSOIudon. don or dtcbIan Of.." a....,~ fIllY 1dIaI! dI!d*lrI.~ ol tile Oty Mar i~ or _ Cay ~ ar ~Clr ;any aatcn, ~ Dr ~Of .'1 r tIy~ ~ I2le Qmt ~o: .1Ie enUrt cIIdIIan-lnI1dng pnlllI!SS en SllCh don. cledIItlIl tlr ltlCOl'ftmendllon thlt Ill/I ~ WIll be heard Dr IDIeMd by"'C :. ClDII'lfI__. or, d/t!t 0aiRd or COl'MlItIiIt. ",. IlIrm ~ IncUSe the plftdpi,l at well. arww ""~ ~ bfobl)yll ,lKtl1riUeS. 1M...... """r~,,"____.~rllll" _............11 _3DM-:MS5. ...!2S. i'iquez NAME Q' ~OUYIST: (Last) Miquel (AI1t) (MJ) .a~.:. t~ Dadt't~ Rap : NAME AND lOO HE 2r:1)Ave - , (Nufnber -S ~ 305-237-3109 m PUIB.: Suit..:: l44n. M; -''''lJ" FL l3132 i~ CD> Code) mi'il1eL ~Qd~igue:dmdc. edu awL: ....lQ3. :i J 1- 3 9 4 4 TB..EIlH: I ~; ,~ , L L,G.,........Y: ~.!,~ o-l$de Colleae' lUME O''NNaPMJtUBft': ~>, . .;1 ~j;aJl., DT"~. r.9~leqe JUSINe..: NAtE IH) ADDRei5 300 m:: 2n<1 Ave. Miami, !: ~ 3-3132 (Nu- and keet) (Qr) (Stlne) (ap COlle) ~i:]'-H44 ~.'IIEMHB: 30~-7~7-11nq fAX NUMBI!R: (0s*nII) miauel.: ['od~iaupz timdro pdn BWL: (Opllanal) .. i~...... .__ II . c.........., ,.... .....~ ., 'Il'lIIt PitdiM 242 (4:: I . 'W'IE Of" 0.18' 0fRCD, PARlNB\. OR BENERCARY: . tDI!NT1fY' AU. ~ HOLDlNCi, DlRfC'I1.TQRlMmUOl.Y. A ~ORMOIU!OWN'J SHIP JNlBESTIN SUCH ;QfUICMnoN.~ ORlRUST: . : IL ~LaeM'-= .t!.Lt!:;41/ ;6o~~".,e IN!';,wi) Ih"""~NI'/ 7:: ~LH h~~ VA~ .... tD 1.1lIbllMd . In ...): DI. CITY MIIICIU,.DMIMM18,.. U..11ED: A) ... t, "'" ., In4I A A.!uI/liIIe " I)AIfr .......... ....... I ~'I n"lWlIUHIIIlp ~I,,,-v ~ .' I ~ 1 - d OOOO-1..E:2-SOE: ::mw dl..~:SO SO 21 ~ew MRImi ~h tqIt1- J.U1I3 m - City of Miami Beach Office of the City Oerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by a prindpal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the atv Manager or any city board or committee; or any action, decision or recommendation of any city personnel during the time period of the entire decision-making process on such action, dedsion or recommendation that foreseeably will be heard or revieYied by the dty commission, or a dty board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The tenn "Lobbyists" h_ specific exclusions. PleBSe refer to Ordinance 2004-3435. Rodriquez NAME OF LOBBYIST: (Last) Miquel (Rrst) (M.!) Miami Dade College BUSINESS NAME AND ADDRESS 300 NE 2nd Ave., (Number and Street) (ety) 305-237-3109 FAX NUMBER: Suite 1440. (State) Minmi FL 33132 (Zip Code) 305-237-3944 TB..EPHONE NUMBER: migue1.rodriguez@mdc.edu EMAIL: I. LOBBYIST RETAINED BY: Miami Dade Col1eqe NAME OF PRINCIPAL/CUENT: MialTIi Dade C9::_1ege BUSINESS NAME AND ADDRESS _ 300 Im 2nd Ave. Miami, FL 33132 (Number and Street) (atv) (State) (Zip Code) 305-237-3944 TELEPHONE NUMBER: ~Oc;-?~7-11()q FAX NUMBER: (Optional) miquel.rodriauez@mdc.edu EMAIL: (Optional) Fill out this section if principelis a Corporation, Partnenhip or Trust [Section 2.....2 (c)) . NAME OF CHIEF OFfICER, PARTNER, OR BENEAOARY: . IDENTIFY AlL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Issue to be lobbied (Describe in detail): III. cnv AGENClES/INDMDUAlS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship N~ _ _~ ____ ____...._._ __. __..~___..........Bealea....ftM 'nTCr.~ 1MM~I!R ~lilLr. ~.~ \t9 Iii llS' 8il . . IV. DISCLO$URE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAnON (DISCLOSE WHETHER HOURLY, RAT RAtE OR OTHER): A) LOBBYIST DI5a.OSURE: (Required) 5"4# V , B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). S /9'-/ /t'Ct t:'j) C;I(",4, ye.a- , , The following InforlMtlon must be answered: 1) Pursuant to Miani Beach Qty Code Section 2-488 EntitJecl "Prohibited Campaign ContrlJutlons By Lobbyists On Procurement Issues": DYes 00.0: Are YOU lobbYIna on . _esent or uencllna bid for aoocIs. eaulDment or services. or on . , --... oresent or __na awn for aoocIs. eauiDment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaigl ConbibutionS By lDbbyists On Real Estate Development Issues": rIVes .~o: :: YOU lobbYina on . aendina ._IClltIon for . DeveIoDment AGreement with the a~ or ~icetion for chanae of zonina ....D desianation or chanae to the Citv's Future Land Use Hm!l 3) Pursuant to Miami Beach Qty Code 2-484 (h) My person (except those exempt from the defi1ition of "lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not-tor-profit corporation or entity without special oompensation or reimbursement tor the appealCl1Ce, whether direct, or indirect, to express support of or opposition to any item, shall register with the clerk as required by this section but, shaD not be required to pay any registration fees.. )lYes 0 No: Are YOU reuresentina a not-for-DI'OfIt COI"DOI'8tion or entitY without SDedaI comaensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, UmNG LOBBYING EXPENDITURES, AS WEU AS COMPENSATION RECEIVED, IN THE cnv OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SIlAU BE mED EVEN IF THERE HAVE BEEN NO EXPEN~ COMPENSAnON DllRING THE REPORTING PERIOD. ~.. ) Signature of Lobbyist I do solemnly swear that all r:J the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in . n 2-482 of the Miami Beach City Code and all reporting requirements. Signature r:llobbyist: Signature r:I Principal/Client: VI. LOBBYIST IDENTlFlCAnON: PRlNQPAL IDENTlFICAnON: ~~~j Inu ~ilJJ ""f"" "'fi~C. . ~. :~ ~ ;~ 3i ~~ ~ ~,~. ~~.,. .",....,," u Produced ID u Produced 10 Form of IcJentification Form of Identification V'Personally known (lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: }!YPersonaIIy known (Principlll) State of florida, County of Miani-[)ade Sworn and Sl.bsaibed before me This -=t-day of /J14Y . 2~ FOR CLERK'S USE ONLY Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR # Date Paid